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- May 28, 2020
Schwartz v. Cal DHCS, Superior Court of California
Abbi Coursolle and Kimberly Lewis CasesRead moreAn adult California Medicaid (Medi-Cal) beneficiary is challenging the California Department of Health Care Services and her county Mental Health Plan after she experienced a mental health crisis and was turned away from evaluation and subsequent treatment without appropriate notice. The Plaintiff alleges that she was denied medically necessary…
- May 21, 2020
Building A Successful Program for Medi-Cal Coverage For Doula Care: Findings From A Survey of Doulas in California
Read moreThe National Health Law Program’s Doula Medicaid Project seeks to improve health outcomes for pregnant Medicaid enrollees by ensuring that all pregnant individuals enrolled in Medicaid who want access to a doula will have one. As part of this project, the National Health Law Program is proud to publish…
- April 8, 2020
Medi-Cal Telehealth Guidance During the COVID-19 Emergency
Read moreThe COVID-19 pandemic has highlighted the importance of telehealth in delivering critical health care when people are not able to receive health services and supplies in person. Consequently, the state is implementing many policy changes to make sure that Californians are receiving the health care they need. Fortunately, California…
- April 8, 2020
Telehealth Guidance for California Private Plans During the COVID-19 Emergency
Read moreIn California, most private health coverage plans are regulated by one of two regulators. California’s Department of Managed Health Care (DMHC) licenses most fully-insured health maintenance organization (HMO) plans in California, including most Covered California plans, and many private individual, small, and large group plans. The DMHC also regulates…
- December 18, 2019
Advocate Fact Sheet: Evaluating Mental Health Plans’ Provision of Medi-Cal Specialty Mental Health Services
Read moreMedi-Cal beneficiaries in California receive mental health services through two separate managed care systems. Medi-Cal Managed Care Plans (MCPs) are responsible for providing non-specialty mental health services and County Mental Health Plans (MHPs) are responsible for providing specialty mental health services (SMHS). This bifurcated system often serves as a…
- October 21, 2019
Internal and External Review: Medi-Cal Managed Care Plans Managed Care in California Series Issue No. 4 (Revised October, 2019)
Read moreFederal and state law and the state and federal Constitutions require that enrollees in Medi-Cal managed care plans receive notice, and grievance and appeal rights when they are denied access to medically necessary services. Frequently, however, enrollees fail to receive the required notice, get an inadequate notice, or do not…